Interdisciplinary Team Information

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The Hospice Interdisciplinary Team (IDT) is a crucial component of hospice care. LDV Hospice focuses on the patient before all else through a comprehensive and holistic supportive approach to individuals with terminal illnesses and their families. LDV utilizes the skills, experience, and knowledge of each member of our team to establish an individualized plan of care based on the needs of each patient, their families, and others directly or indirectly involved in the patient's care, to ensure that the highest level of comfort, and the best quality of life, is achieved based on where a patient is at in their life’s journey. The Interdisciplinary Team (IDT) considers all aspects of a patient's wellbeing: the physical, emotional, spiritual, and psychological, and provides symptom management with care and compassion. The IDT is comprised of the Medical Director, Registered Nurse, Hospice Aide, Medical Social Worker, and Spiritual Counselor.

Your Medical Director is responsible for overseeing the patient's medical care, collaborating with the primary care physician, and providing guidance on pain and symptom management. The medical director assumes and maintains the overall responsibility for the determination and delivery of the medical care of the hospice patient for the duration of their Hospice Care. The medical director joins the patient, family and caregivers on the hospice journey with a wholistic approach to compassionate care.

Registered Nurse Case Manager (RNCM) is responsible for overseeing the patient's medical care, collaborating with the primary care physician, and providing guidance on pain and symptom management. Your RNCM is responsible for the first line of patient care, comfort, and symptom management. The RNCM works closely with patients and their family and/or caregiver to determine the best approach to symptom management while providing extensive education on what to expect as the terminal disease process progresses, medications and non-medication interventions. The RNCM is a gentle hand to hold, and an open ear to listen to your concerns and your needs to ensure that all members of the IDT can make your journey as easy as possible. The RNCM will help with establishing a visit routine that is best for the patient, their family and/or caregiver. The RNCM ensures the patient has the medications, supplies, and medical equipment needed to achieve the highest level of comfort and quality of life.

Your Certified Nurse Assistant (CNA) is responsible for assisting our patients with activities of daily living personal care. CNA’s follow an established plan of care developed by the IDT with the patient and caregiver to meet the personal needs of our patients under the supervision of the hospice nurse. At LDV Hospice we believe that a visit takes as long as a visit needs to take to ensure that the personal care needs of our patients are met in a supportive and caring manner. At LDV Hospice, we provide a supportive system for our CNA’s to establish a rapport that will allow for a high level of care to be delivered with kindness and compassion.

Your Medical Social Worker will perform a comprehensive evaluation to determine the psychosocial needs of each of our patients and their families. Your MSW will assist with community resources, insurance paperwork, and end of life planning. Your MSW will be a hand to hold and an open ear to listen to provide emotional and grief support, or a kind work and a light laugh. Your MSW can assist with counseling or act as an intermediary with living facilities should a breakdown in communication arise. At LDV Hospice, we believe the emotional and psychosocial well-being of our patients is a key component of symptom management and ultimately your quality of life.

Your Spiritual Counselor will perform a comprehensive evaluation to determine the spiritual needs and how best to provide support. Your Spiritual Counselor provides emotional and spiritual support for the patient and their family while providing education to the patient and their family on how to cope with the fears of uncertainty that may arise towards the end of life. Your Spiritual Counselor can assist with funeral planning as well as performing funeral services if a family wishes, but most importantly they will provide emotional support, spiritual support, an open mind, and a listening ear to provide peace of mind and spirit. Spiritual counselor support does not end with the last breath, family will continue to receive support for a minimum of 13 months through bereavement care.